1. Field of the Invention
The present invention relates generally to preventing, treating, and/or relieving decubitus ulcers and, more particularly, to a device that reduces or eliminates heel pressure while the leg is extended, and that allows for and does not impede ambulation while the device is in place.
2. Background Information
Because of its thin layer of subcutaneous tissue between the skin and bone, the heel is the second most common site for pressure ulcer development (after the sacrum). Heel ulcers are costly and, if not treated promptly and properly, may lead to osteomyelitis and even limb amputation. Pressure ulcers of the heel may occur in individuals who for any reason spend extended periods of time in bed, and/or who may suffer from certain diseases or ailments making them prone to ulcers even without extended bedrest. For instance, heel ulcers often occur in patients with immobile legs due to health care problems such as fractured hips, joint replacement surgery, spinal cord injury, Guillain-Barré syndrome, or stroke, who do not move their legs because of paralysis, weakness, or pain. Diabetic patients are also susceptible to heel ulcers, as these patients may not feel foot pressure or injuries because of peripheral neuropathy, increasing the likelihood for heel ulcers even without extended bedrest or leg elevation. Further, immobile diabetic patients may have trouble moving their legs, thus exacerbating the decubitus conditions that cause heel ulcers. Patients who have leg spasms, or who are otherwise confused, may rub their heels on the bed and abrade the heel. Patients may also dig their heels into the mattress to keep from sliding down in bed, causing further pressure injury.
Effective heel ulcer treatment and prevention involves reducing pressure, friction, and shear on the heel; separating and protecting the ankles; maintaining heel pressure reduction or suspension; and preventing footdrop, even under patient movement. The apparatus should also be comfortable for the patient, easy for the caretakers to use, and permit repositioning without increasing pressure in other areas. While there are quite a few devices and techniques currently being used, none of them are able to adequately address these and other considerations for effective heel ulcer treatment and prevention.
One bedside technique widely used by caretakers is positioning a pillow, rolled towel, or folded bath blanket under the lower leg region to elevate or suspend the foot off the bed to avoid contact of the heel with the bed. In this case, the towel should be placed under the calf and not under the Achilles tendon, as using a rolled towel under the Achilles tendon to lift the leg for more than a day or two may injure the Achilles tendon. Improper positioning and/or excessive height of such improvised elevating devices may hyper-extend the knee. Such improvised bedside techniques, therefore, are evidently not well controlled, and may not only be ineffective in preventing heel pressure, but also may lead to other injuries.
Numerous leg elevating products are marketed that act like special-purpose pillows or cushions upon which the leg and/or foot rests. Such products may be well suited for patients with immobile legs, such as those recovering from hip and knee surgery or stroke. Because these devices generally are not securely attached to the patient, they typically do not adequately protect the patient's heel from pressure, abrasion, and/or shear as the patient moves or changes body position. Accordingly, if the patient is at risk for moving her leg off the device, or if her leg needs to be elevated longer than a few days, then it may be better to use a product that stays on the foot during movement.
Many heel protection devices that are attachable to the leg and/or foot are marketed. Although such a device may be selected for use on patients who are able to move their leg and who thus may be able to ambulate, typically the device itself prevents or otherwise impedes ambulation, and generally must be entirely removed for ambulation, and then repositioned and reattached when the patient returns to the bed. Additionally, many of these devices encase or enclose the heel, thus not providing for the elimination of heel pressure, and not providing much advantage other devices and techniques for preventing heel abrasion by reducing friction from shearing and rubbing, such as various moisturizers, socks, and dressings (such as films or hydrocolloids).
Therefore, in view of the background information presented hereinabove, the need is manifest for advances in decubitus ulcer prevention and treatment, and particularly for the prevention and treatment of heel ulcers.